Reynolds backs Graham-Cassidy health care approach

Bill would give states more control but, critics say, less money

By Rod Boshart, Gazette Des Moines Bureau | Sep 20, 2017

DES MOINES — Gov. Kim Reynolds said Tuesday she supports a GOP plan that would end the “big bureaucratic” Affordable Care Act approach by giving more flexibility to states in how they use federal dollars to address the health care of their residents.

Reynolds said at her weekly news conference she is joining 20 other governors in supporting the Graham-Cassidy-Heller-Johnson legislation being offered in the U.S. Senate that would repeal Obamacare and send federal money for the health care law to the states as block grants.

“Right now what we have is not working. It’s unsustainable, it’s unworkable and it’s collapsing before our very eyes,” she told reporters. “People were sold a bill of goods on Obamacare.”

Reynolds said the block grant approach worked in reforming the welfare system by giving states the flexibility to craft their own approaches to managing their cases, which helped to significantly lower the welfare rolls while helping people function independently instead of relying on government assistance.

The Republican governor said she envisioned a system that would pass through funds, not shift costs, to the state level where officials then could focus on preventive measures, better medication management and other approaches designed to produce healthy outcomes.

“I believe right now that’s the only vehicle we have to fix a broken system,” Reynolds said. “It can work. I believe right now this is the only vehicle that we have to address Obamacare that is failing.”

However, the Democratic National Committee came out against Graham-Cassidy approach to replacing the Affordable Care Act, calling it “the worst Republican repeal bill yet.”

Also Tuesday, a bipartisan group of 10 governors came out in opposition to the latest GOP attempt to repeal the Affordable Care Act. Four Republicans, five Democrats and independent Alaska Gov. Bill Walker signed a letter to Senate Majority Leader Mitch McConnell, R-Ky., and Senate Minority Leader Chuck Schumer, D-N.Y., urging against consideration of the Graham-Cassidy plan — which repeals Obamacare's individual and employer mandates and replaces subsidies with block grants. Instead, the governors said they were in favor of the ongoing bipartisan efforts to hammer out a bipartisan agreement for legislation that would stabilize the individual market.

Democratic gubernatorial candidate Nate Boulton, a Des Moines state senator, was critical of Reynolds for supporting a plan that would cut federal matching funds and grants to Iowa.

“The Graham-Cassidy Block Grant Health Care bill will cause Iowans to lose $2.3 billion by 2027, worsening the burdens on low- and middle-income families, especially those with disabilities, seniors and children as they struggle to access quality health care,” he said in a statement.

“This administration has already defunded Planned Parenthood, closed two of our four state mental health institutions and privatized Medicaid,” he added. “Iowans deserve improvements to our health care system, not further cuts to a system already at risk.”

Short term, Reynolds said her focus is on stabilizing Iowa’s collapsing individual insurance market. She said she hopes a decision will come soon on federal approval of a short-term waiver that would redirect Obamacare subsidies for 2018 so Iowans would have more private insurance options. Enrollment begins in November.

“I can tell you that all parties want to get to yes, so I’m cautiously optimistic because doing nothing is not an option,” Reynolds said.

On another health care topic, Reynolds defended Iowa’s decision to switch most of its $5 billion Medicaid program to privately managed care, saying the system that commenced in April 2016 is “not perfect” but is working to replace a fee-for-service approach that was not sustainable or affordable for taxpayers.

Another Democrat running for governor in 2018, Dr. Andy McGuire, said the stories she is hearing from Iowans in traveling the state is that Medicaid patients are not being served well by the system being run by three private managed care organizations.

“Today, Gov. Reynolds defended Medicaid privatization by saying, ‘It takes time’. Iowa’s most vulnerable citizens simply can’t afford to wait any longer,” McGuire said in a statement. “If Gov. Reynolds is serious about making the health care of Iowa’s most vulnerable citizens a priority then she needs to admit when she is wrong, and call Medicaid privatization what it is---a mistake.”